Fluoxetine versus sertraline and paroxetine in major
depressive disorder: changes in weight with long-term treatment.

Fava M, Judge R, Hoog SL, Nilsson ME, Koke SC.

Massachusetts General Hospital, Boston 02114, USA. mfava@partners.org

BACKGROUND: The effects of extended selective serotonin reuptake
inhibitor (SSRI) treatment on weight are not well characterized. Also
unknown is whether different agents have differential effects. To examine
these questions, we assessed weight changes in patients randomly assigned
to long-term treatment with fluoxetine, sertraline, or paroxetine. METHOD:
Patients (N = 284) with major depressive disorder (DSM-IV) were randomly
assigned to double-blind treatment with fluoxetine (N = 92), sertraline,
(N = 96), or paroxetine (N = 96) for a total of 26 to 32 weeks. The mean
percent change in weight was compared for each group, as was the number of
patients who had > or = 7% weight increase from baseline. RESULTS:
Patients (fluoxetine, N = 44; sertraline, N = 48; paroxetine, N = 47) who
completed the trial were included in these analyses. Paroxetine-treated
patients experienced a significant weight increase, fluoxetine-treated
patients had a modest but nonsignificant weight decrease, and patients
treated with sertraline had a modest but nonsignificant weight increase.
The number of patients whose weight increased > 7% from baseline was
significantly greater for paroxetine-treated compared with either
fluoxetine-treated or sertraline-treated patients. CONCLUSION: Risk of
weight gain during extended SSRI treatment differs depending on which SSRI
is used.